Remote Australia looks for better satellite infrastructure

Written by Fiona McCaul on 23 May 2013.

Healthcare providers, technical experts and Medicare Locals are currently working on a proposal for funding to improve telecommunications infrastructure in remote parts of Australia, with the aim of improving access to healthcare more quickly.

The proposal is being developed based on the outcomes of the Satellite and Telehealth Conference hosted by the Kimberley-Pilbara Medicare Local (KPML) in Broome in March.

The conference, which brought together delegates from Western Australia, South Australia and the Northern Territory, discussed ways to streamline and enhance satellite-based internet connections for primary, allied health and aged care in remote areas.

In advance of the federal government's planned launch of two long-term broadband satellites in 2015, the conference discussed how improvements could be made in the short-term, leading to a draft proposal for funding that is shortly to be submitted to government.

The conference brainstormed some of the technical issues facing remote areas and aimed to develop a replicable approach to satellite links in a region of over 4.8 million kilometres, or 62.3 per cent of Australia’s land mass.

“Technology can provide a huge benefit to healthcare provision in remote areas but there are still enormous challenges,” KPML chief executive officer Chris Pickett said. “The purpose of this event was for the first time to bring all providers together to look at the challenges and more importantly, the solutions and ultimate benefits to health provision through enhanced technology.”

The conference heard how limited or erratic access to the internet meant that new technologies in eHealth and telehealth were often unavailable, and how reliable satellite links would improve access to healthcare.

Puntukurnu Aboriginal Medical Services (PAMS), for example, has clinics in four remote central Western Australian desert communities – Punmu, Jigalong, Parnngurr and Kunnawaritji – with a new clinic recently opened in the mining township of Newman.

PAMS' chronic disease self-management co-ordinator, Megan Ewing, explained how despite the remoteness, it had rolled out commercial-grade satellite dishes and electronics in 2011, and had installed the MMEx electronic health record developed by the University of Western Australia.

During the implementation, each clinic had a satellite dish installed in arduous conditions by a small, dedicated team. PAMS admits that the installations are a bit crude, in that the satellite dishes on ground mounts are anchored by bags of quick-set cement, but that nonetheless, the installations had not yet missed a beat.

The satellite dishes and other equipment like a satellite modem had to be fitted into tailor-made travel boxes to fit the required size limit for the regular mail flight that visits the communities.

The boxes were designed this way so that when there were technical issues, the box could be easily unplugged and sent back to base on the mail flight, fixed then returned via the mail flight.

“This is an excellent system for the community as there is no cost due to bulk billing,” Ms Ewing said.

PAMS has also implemented the web-based MMEx platform for shared care, she said. The indigenous people living in the region, the Martu, often travel between communities and to regional centres for healthcare by referral.

“Having an accessible health record facilitates cultural sensitivity for the Martu and without question is an eHealth risk management safety factor in the delivery of safe informed healthcare,” Ms Ewing said.

“Real-time eHealth shared care is paramount in the continuity of care for the Martu and is considered gold standard in risk management and best practice in the delivery of healthcare.”

She used the example of a Martu person from Jigalong who was visiting Kunawarritji on the Canning Stock Route who required medical treatment.

“The clinic nurse, who is usually a FIFO health professional, is able to access the patient’s health record and determine the patient’s medical history, the last event summary, their adverse and allergy status and the current medication list,” Ms Ewing said.

“The nurse is able to use the information to guide her clinical decision-making and consult the PAMS medical practitioner either in Newman or Jigalong if necessary. The consultation is documented as an entry to the patient’s MMEx eHealth record.”

Delegates to the conference identified a number of challenges most of them experience, especially those posed by geographical magnitude and its effect on access to hospitals, specialists and allied healthcare providers.

The effects of climatic conditions on satellites and technical equipment – from cyclones, harsh temperatures in the deserts, sandstorms and violent storms during the wet season – were also discussed.

Cost and speed are also major challenges. While many used different telehealth tools like Skype, Facetime, Lync and Scopia, they all agreed that the needs were the same.

Those needs were efficient and stable satellite communications and for increased speed and bandwidth to enable best practice and access in eHealth.

They also need more cost-efficient satellite connection contracts. Many health services are paying in excess of $1200 per month for services that cost about $60 per month in the cities.